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Head Neck ; 41(12): 4209-4228, 2019 12.
Article in English | MEDLINE | ID: mdl-31502752

ABSTRACT

BACKGROUND: We investigated the efficacy of hyperbaric oxygen (HBO), low-intensity laser (LIL), and platelet-rich plasma (PRP) in the management of medication-related osteonecrosis of the jaws (MRONJ). METHODS: A literature search was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Two examiners independently assessed eligibility and risk of bias and extracted data. RESULTS: There was improvement in 75.6% of the 41 patients submitted to HBO, with positive effects on pain relief and decreased size and number of lesions at a faster rate, with better effects when the drug was discontinued. For LIL, 158 (64.2%) of the 246 patients/sites improved the symptoms and 98 (39.8%) healed completely. Fourteen (17.3%) of the 81 patients treated with PRP significantly improved the symptoms and 65 (80.2%) completely healed. CONCLUSIONS: These therapies served as safe and effective adjuvant modalities for MRONJ treatment. The lack of randomized clinical trials evidences the need for more high-quality investigations on the subject.


Subject(s)
Bisphosphonate-Associated Osteonecrosis of the Jaw/therapy , Hyperbaric Oxygenation/methods , Laser Therapy/methods , Platelet-Rich Plasma , Aged , Aged, 80 and over , Bisphosphonate-Associated Osteonecrosis of the Jaw/pathology , Bone Density Conservation Agents/adverse effects , Combined Modality Therapy , Denosumab/adverse effects , Diphosphonates/adverse effects , Female , Humans , Jaw Diseases/chemically induced , Jaw Diseases/therapy , Male , Middle Aged , Osteonecrosis/chemically induced , Osteonecrosis/therapy , Pain Management , Pamidronate/adverse effects , Randomized Controlled Trials as Topic
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